Publications

Recent Publications are shown below in order of publication. To browse by journal name, author name or date see left sidebar. To search by general keywords use search box on the right side of this page.

Climate change will disproportionately affect the poor in the future, nowhere more so than in the fragile ecological zone known as the Sahel. The Sahel has been plagued with droughts, decreasing crop yields, and increasing environmental degradation (World Bank, 2013). This paper will empirically demonstrate that an integrated intervention, coupling access to family planning (FP) [...]

Women from Burma living in Thailand are generally unable to access safe abortion care—even for cases that clearly fall within the legal exceptions—because of a lack of knowledge of the Thai medical and legal systems, restrictions on travel and movement, [...]

Despite high rates of unintended pregnancy, access to a wide range of contraceptive methods, especially injectables and long-acting reversible contraceptives (LARCs), is severely limited in both public and private facilities. Knowledge of contraceptive choices is likewise limited, yet a substantial proportion of women are not using their preferred method among the methods they know of.Read MoreDownload PDF

Objective
To provide a cost analysis of an injectable contraceptive program combining community-based distribution and social marketing in Tigray, Ethiopia.
Methods
We conducted a cost analysis, modeling the costs and programmatic outcomes of the program’s initial implementation in 3 districts of Tigray, Ethiopia. Costs were estimated from a review of program expense records, invoices, and [...]

Empowerment is widely acknowledged as a process by which those who have been disempowered are able to increase their self-efficacy, make life-enhancing decisions, and obtain control over resources [1, 2, 3]. In addition, empowerment is multi-dimensional – a woman may be empowered in one dimension or sphere [...]

Abstract: We reviewed existing evidence of the efficacy of postpartum family planning interventions targeting women in the 12 months postpartum period in low- and middle-income countries. We searched for studies from January 1, 2004 to September 19, 2015, using the US Preventive Services Task Force recommendations to assess evidence quality. Our search resulted in 26 [...]

Abstract: Abortion stigma is influenced by a variety of factors. Previous research has documented a range of contributors to stigma, but the influence of perceived social norms about contraception has not been significantly investigated. This study assesses the influence of perceived social norms about contraception on abortion stigma among women in Luanda, Angola. This analysis uses data from the 2012 Angolan Community Family Planning Survey. Researchers employed multi-stage random sampling to collect demographic, social, and reproductive information from a representative sample of Luandan women aged 15–49. Researchers analyzed data from 1469 respondents using chi-square and multiple logistic regression. Researchers analyzed women’s perceptions of how their partners, friends, communities, and the media perceived contraception, and examined associations between those perceptions and respondents’ abortion stigma. Stigma was approximated by likelihood to help someone get an abortion, likelihood to help someone who needed medical attention after an abortion, and likelihood to avoid disclosing abortion experience. Higher levels of partner engagement in family planning discussion were associated with increased stigma on two of the three outcome measures, while higher levels of partner support of contraception were associated with decreased stigma. Perceived community acceptance of family planning and media discussion of family planning were associated with a decrease in likelihood to help someone receive an abortion. These results suggest that increasing partner support of family planning may be one strategy to help reduce abortion stigma. Results also suggest that some abortion stigma in Angola stems not from abortion itself, but rather from judgment about socially unacceptable pregnancies.

Abstract: Family planning programs have made vast progress in many regions of sub-Saharan Africa in the last decade, but francophone West Africa is still lagging behind. More emphasis on male engagement might result in better outcomes, especially in countries with strong patriarchal societies. Few studies in francophone West Africa have examined attitudes of male involvement in family planning from the perspective of men themselves, yet this evidence is necessary for development of successful family planning projects that include men. This qualitative study, conducted in 2016, explored attitudes of 72 married men ages 18–54 through 6 focus groups in the capital of Togo, Lomé. Participants included professional workers as well as skilled and unskilled workers. Results indicate that men have specific views on family planning based on their knowledge and understanding of how and why women might use contraception. While some men did have reservations, both founded and not, there was an overwhelmingly positive response to discussing family planning and being engaged with related decisions and services. Four key findings from the analyses of focus group responses were: (1) socioeconomic motivations drive men’s interest in family planning; (2) men strongly disapprove of unilateral decisions by women to use family planning; (3) misconceptions surrounding modern methods can hinder support for family planning; and (4) limited method choice for men, insufficient venues to receive services, and few messages that target men create barriers for male engagement in family planning. Future attempts to engage men in family planning programs should pay specific attention to men’s concerns, misconceptions, and their roles in family decision making. Interventions should educate men on the socioeconomic and health benefits of family planning while explaining the possible side effects and dispelling myths. To help build trust and facilitate open communication, family planning programs that encourage counseling of husbands and wives in their homes by community health workers, trusted men, or couples who have successfully used or are currently using family planning to achieve their desired family size will be important.

Conclusion: History of induced abortion was associated with use of a modern contraceptive method in our study population. The most common contraceptive used by women with a history of induced abortion was condoms, indicating that despite adoption of a modern method, many women are still at risk for an unintended pregnancy. Further research is needed to understand the causal factors underlying women’s postabortion contraceptive choices.

Unsafe abortion is one of the three leading causes of maternal mortality in low-income countries; however, few countries have reformed their laws to permit safer, legal abortion, and professional medical associations have not tended to spearhead this type of reform. Support from a professional association typically carries more weight than does that from an individual medical professional. However, theory predicts and the empirical record largely reveals that medical associations shy from engagement in conflictual policymaking such as on abortion, except when professional autonomy or income is at stake. Using interviews with 10 obstetrician–gynaecologists and 44 other leaders familiar with Ethiopia’s reproductive health policy context, as well as other primary and secondary sources, this research examines why, counter to theoretical expectations from the sociology of medical professions literature and experience elsewhere, the Ethiopian Society of Obstetricians & Gynecologists (ESOG) actively supported reform of national law on abortion. ESOG leadership participation was motivated by both individual and ESOG’s organizational commitments to reducing maternal mortality and also by professional training and work experience. Further, typical constraints on medical society involvement in policymaking were relaxed or removed, including those related to ESOG’s organizational structure and history, and to political environment. Findings do not contradict theory positing medical society avoidance of socially conflictual health policymaking, but rather identify how the expected restrictions were less present in Ethiopia, facilitating medical society participation. Results can inform efforts to encourage medical society participation in policy reform to improve women’s health elsewhere in sub-Saharan Africa.

Upcoming Events

Quick Links

About

The Bixby Center for Population, Health, and Sustainability is dedicated to helping achieve slower population growth within a human right framework by addressing the unmet need for family planning. Learn more